Interest in the percutaneous or transdermal delivery of peptides and proteins to the human body continues to grow with the increasing number of medically useful peptides and proteins becoming available in large quantities and pure form. The transdermal delivery of peptides and proteins still faces significant problems. In many instances, the rate of delivery or flux of polypeptides through the skin is insufficient to produce a desired therapeutic effect due to their large size/high molecular weight and the resulting inability to pass through natural pathways (pores, hair follicles, etc.) through skin. In addition, polypeptides and proteins are easily degradable during penetration of the skin, prior to reaching target cells. Likewise, the passive flux of water soluble small molecules such as salts is limited.
One method of increasing the transdermal delivery of agents relies on the application of an electric current across the body surface or on "electrotransport". "Electrotransport" refers generally to the passage of a beneficial agent, e.g., a drug or drug precursor, through a body surface such as skin, mucous membranes, nails, and the like. The transport of the agent is induced or enhanced by the application of an electrical potential, which results in the application of electric current, which delivers or enhances delivery of the agent. The electrotransport of agents through a body surface may be attained in various manners. One widely used electrotransport process, iontophoresis, involves the electrically induced transport of charged ions. Electroosmosis, another type of electrotransport process, involves the movement of a solvent with the agent through a membrane under the influence of an electric field. Electroporation, still another type of electrotransport, involves the passage of an agent through pores formed by applying a high voltage electrical pulse to a membrane. In many instances, more than one of these processes may be occurring simultaneously to different extents. Accordingly, the term "electrotransport" is given herein its broadest possible interpretation, to include the electrically induced or enhanced transport of at least one charged or uncharged agent, or mixtures thereof, regardless of the specific mechanism(s) by which the agent is actually being transported. Electrotransport delivery generally increases transdermal flux of agents, particularly large molecular weight species (e.g., polypeptides), relative to passive or non-electrically assisted transdermal delivery. However, further increases in transdermal delivery rates and reductions in polypeptide degradation during transdermal delivery are highly desirable.
One method of increasing the agent transdermal delivery rate involves pre-treating the skin with, or co-delivering with the beneficial agent, a skin permeation enhancer. The term "permeation enhancer" is broadly used herein to describe a substance which, when applied to a body surface through which the agent is delivered, enhances its flux therethrough. The mechanism may involve a reduction of the electrical resistance of the body surface to the passage of the agent therethrough, an increase in the permselectivity and/or permeability of the body surface, the creation of hydrophilic pathways through the body surface, and/or a reduction in the degradation of the agent (e.g., degradation by skin enzymes) during electrotransport.
There have been many attempts to mechanically disrupt the skin in order to enhance transdermal flux, such as, U.S. Pat. Nos. 3,814,097 issued to Ganderton et al., 5,279,544 issued to Gross et al., 5,250,023 issued to Lee et al., and 3,964,482 issued to Gerstel et al., U.S. Pat. No. Re. 25,637 issued to Kravitz et al. and published PCT applications WO 96/37155; WO 97/48440; and WO 97/48441. These devices typically utilize tubular or cylindrical structures generally, although the Gerstel U.S. Patent and the latter two PCT publications do disclose the use of other shapes, to pierce the outer layer of the skin. The piercing elements disclosed in these references generally extend perpendicular from a thin flat member, such as a pad or metal sheet, which is placed on the skin surface. The flexible nature of the flat member and the tubular shape of the piercing elements result in a variety of short-comings, such as manufacturing difficulties, flexing of the flat member when pressure is applied to the top of the device, uneven or poor penetration of the skin by the microblades or microtubes resulting in low transdermal agent flux and, for electrotransport, increased irritation due to concentrating the drug flux through fewer pathways.
A further shortcoming of the devices disclosed in WO 97/48440 and WO 97/48441 concerns the degree of difficult in their manufacture. First, the thin flexible metallic sheets/plates must be subjected to a photoetching process to form openings in the sheet/plate through which the agent being transdermally delivered or sampled can pass. The photoetching is also used to form the microblades. However, a second punching step is required to bend the microblades to an angle roughly perpendicular to the plane of the sheet. Because of the tiny size of the openings (about 0.4=0.5 mm) and because of the large number of openings (about 50 to 300 openings/cm.sup.2), accurate alignment of the micropunches with the microopenings is problematic and time consuming.